Provider Demographics
NPI:1396515276
Name:RIVERA, KIARA
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 ALAN PAGE DR SE APT 10
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-3742
Mailing Address - Country:US
Mailing Address - Phone:561-425-3036
Mailing Address - Fax:
Practice Address - Street 1:712 ALAN PAGE DR SE APT 10
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-3742
Practice Address - Country:US
Practice Address - Phone:561-425-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide